Hacker News Reader

Comment by sradman | Hacker News Reader

> as Theranos demonstrated so vividly, it is harder to sustain a hype balloon in a scientific enterprise than in many of the markets where Silicon Valley has prospered.

This narrative continues to frustrate me. Eleanor Roosevelt famously said:

> Great minds discuss ideas; average minds discuss events; small minds discuss people.

The big idea behind Theranos was that combining multiple microfluidic tests could produce a lab-on-a-chip. Theranos failed to combine more than a handful of microfluidics together and scrambled to find alternatives to bridge the gap.

Ultimately they were foiled by brain-dead regulatory tests that specified blood draw volumes of blood. This regulatory test has to change to accommodate fingerpick volumes of blood; a key feature of microfluidic tests.

Our collective small minds couldn’t focus on anything but the people involved. The core idea is still an outstanding hard problem.

View on HN

> Ultimately they were foiled by brain-dead regulatory tests that specified blood draw volumes of blood. This regulatory test has to change to accommodate fingerpick volumes of blood; a key feature of microfluidic tests.

As I understand it, for many of the tests Theranos was aiming to do there's no real way to achieve it with the tiny volumes of blood they were trying to use: the concentrations of the substance they were testing for were so low the statistical variation of the amount in any given small volume of blood would invalidate the test, even if you could accurately count it.

> for many of the tests Theranos was aiming to do there's no real way to achieve it with the tiny volumes of blood they were trying to use

This is exactly the right question to ask. Right from the start we should have had a scorecard of the common lab tests doctors request (under 50 I think). For each test you should ask “is it possible with microfluidics?” and then “has it been combined on a single strip/card yet?”

I’m not sure if any concentrations are too low for microfluidics rather than the dilution required to meet the volumes specified in the standardized tests. Are fingerpick volumes too small or are the regulatory tests outdated?

The same issue applies to self administered rapid antigen tests during the pandemic. Regulators focused on the “gold standard" PCR tests and ignored the benefit of cheap and easy unamplified tests that can be used in a daily regiment.

They focused on the people because they were either scammers or well-known people with no domain knowledge.

The basic idea was very straightforward. I can come up with lots of great ideas if I ignore whether there's any reasonable path to a solution. Hey! Let's have a Star Trek medical tricorder implemented in a watch. Let me know when you're done implementing it. I'll be at the beach.

Nothing to do with regulator bogeyman.

> They focused on the people because they were either scammers

The scamming came after the failure of the core premise of the startup: microfluidic lab-on-a-chip. My point was not to excuse the scamming, it was to switch focus back to the core ideas and not the people sporting black turtlenecks.

I suspect that if the original strategy worked the story would be different. Transparently reporting technical/business failure is an admirable trait but it is a different thing than innovation. Journalists and analysts should have been reporting on the scorecard (strategy/tactics/execution). When the company did a technical pivot why was this not enough to investigate the underlying cause? I'm a potential customer that wants this solution; I feel like I've been cheated by all involved.

QUESTION: if someone else succeeds with a microfluidic lab-on-a-chip can the regulators validate its efficacy?

Presumably they compare the results with those from known good tests.

Reply on news.ycombinator.com